This article is a commentary on:
Working with patients’ treatment expectations – what we can learn from homeopathy
Simonetta Bernardini1†
Andrea Dei2*†‡- 1Italian Society of Homeopathy and Integrated Medicine (SIOMI), Firenze, Italy
- 2Department of Chemistry, Lamm Laboratory, INSTM Research Unit, University of Florence, Florence, Italy
A Commentary on
Working with patients' treatment expectations – what we can learn from homeopathy
by Wilhelm, M., Hermann, C., Rief, W., Schedlowski, M., Bingel, U., and Winkler, A. (2024). Front. Psychol. 15:1398865. doi: 10.3389/fpsyg.2024.1398865
Introduction
In a recent work Wilhelm et al. (2024) propose a therapeutic model based on the placebo effect, as they believe occurs in the practice of homeopathic medicine, according to their literature data, which suggest that homeopathic medicines contain no molecules of active principle. We do not wish here to discuss the correctness or otherwise of the proposed therapeutic model, as it is outside our expertise. Rather, we want to highlight that the hypothesis underlying their reasoning is profoundly questionable: indeed, following their view, there is no relationship between the efficacy of the therapy and the specific character of the homeopathic remedies. It is here emphasized that this relationship exists as recent available meta-analyses have shown (e.g., Hamre et al., 2023). We want to highlight that the hypothesis of Wilhelm et al. underlying their reasoning is not supported by scientific data. A detailed analysis of this proposition can be found in the recent literature (Weiermayer et al., 2022).
Discussion
There is no doubt that the debate on homeopathy has been conducted for decades by both proponents and their critics on the basis of prejudice and nonsense, given that experimental data were very limited. Added to this consideration, it is worth mentioning that the misinterpretation of the essence of their own therapeutic modality, as many homeopaths still today are proposing, does not stimulate industries to promote the necessary investments in appropriate research programs: the lack of a well-defined scientific platform has strongly limited the development of the discipline. However, now the situation is profoundly different, and even a superficial examination of the recent scientific literature provides clear evidence in that sense (Dei, 2020, 2024). Indeed, experimental data suggest that the therapeutic methodology should be widely reviewed in its essence, although this perspective is poorly understood and poorly received by both parties. For simplicity, we remind the authors that, contrary to what is postulated in the first words of their work, it has been shown that the ultra-diluted solutions of homeopathic remedies are found to contain a number of active principle molecules of the order of magnitude of the cells of our organism (Chikramane et al., 2012). In a recent report the authors were able to obtain the diffractometric crystal structure of the drug molecules populating a formally believed 10−60 M solution (Rath et al., 2024). Further, such solutions are capable of inducing relevant biological effects concerning both gene expression and the defence response of individual cells (Khuda-Bukhsh, 1997; Bigagli et al., 2014), which to our knowledge are not characterized by the placebo effect. These results have been obtained using both the DNA-array technique and appropriate chemical-physical investigation techniques, and the experimental data are indisputable. Furthermore, studies conducted at various dilutions show that the response of the biological substrate to the disturbance induced by the drug generally follows a hormetic mechanism (Dei and Bernardini, 2015), a biphasic response that, at a psychological level, of which the authors are undoubtedly experts, is difficult to justify.
These statements, now accepted by the scientific literature, in fact, nullify the validity of the starting hypothesis of the model proposed by Marcel Wilhelm and colleagues, who, despite their claims to be inspired by EBM, demonstrate that they do not know the first rule of the scientific method, which favors the exact over the claimed true in the definition of reality. Even if, and it is not up to us to say, the scientific experiment indicates that the human mind is capable of inducing the overexpression of certain genes and the underexpression of others (Seetharaman et al., 2021), a fact that is well-known to be exploited in healthcare practice, including the so-called integrated medicine, and is re-proposed by Wilhelm and colleagues in their work. But this feature does not specifically characterize the homeopathic methodology.
Author contributions
SB: Writing – original draft, Writing – review & editing. AD: Writing – original draft, Writing – review & editing.
Funding
The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
References
Bigagli, E., Luceri, C., Bernardini, S., Dei, A., Filippini, A., and Dolara, P. (2014). Exploring the effects of homeopathic Apis mellifica preparations on human gene expression profiles. Homeopathy 103, 127–132. doi: 10.1016/j.homp.2014.01.003
Chikramane, P. S., Kalita, D., Suresh, A. K., Kane, S. G., and Bellare, J. R. (2012). Why extreme dilutions reach non-zero asymptotes: a nanoparticulate hypothesis based on froth flotation. Langmuir 28, 15864–15875. doi: 10.1021/la303477s
Dei, A. (2020). Experimental evidence supports new perspectives in homeopathy. Homeopathy 109, 256–260. doi: 10.1055/s-0040-1701445
Dei, A., and Bernardini, S. (2015). Hormetic effects of extremely diluted solutions on gene expression. Homeopathy 104, 116–122. doi: 10.1016/j.homp.2015.02.008
Hamre, H. J., Glockmann, A., von Ammon, K., Riley, D. S., and Kiene, H. (2023). Efficacy of homoeopathic treatment: systematic review of meta-analyses of randomised placebo-controlled homoeopathy trials for any indication. Syst. Rev. 12:191. doi: 10.1186/s13643-023-02313-2
Khuda-Bukhsh, A. (1997). Potentized homoeopathic drugs act through regulation of gene-expression: a hypothesis to explain their mechanism and pathways of action in vitro. Comp. Ther. Med. 5, 43–46. doi: 10.1016/S0965-2299(97)80090-8
Rath, S., Jema, J. P., Kesavan, K., Mallick, S., Pradhan, J., Chainy, G. B. N., et al. (2024). Arsenic album 30C exhibits crystalline nano structure of arsenic trioxide and modulates innate immune markers in murine macrophage cell lines. Sci. Rep. 14:745. doi: 10.1038/s41598-024-70287-9
Seetharaman, M., Krishnan, G., and Schneider, R. H. (2021). The future of medicine: frontiers in integrative health and medicine. Medicina 57:1303. doi: 10.3390/medicina57121303
Weiermayer, P., Keusgen, M., Pannek, J., Panhofer, P., Geiger, M., Etter-Kalberer, G., et al. (2022). How is evidence-based medicine defined? Homeopathy-a therapeutic option in medical practice! HNO 70, 72–74. doi: 10.1007/s00106-021-01122-0
Keywords: homeopathy, placebo, treatment expectation, evidence-based medicine, integrative medicine
Citation: Bernardini S and Dei A (2024) Commentary: Working with patients' treatment expectations – what we can learn from homeopathy. Front. Psychol. 15:1477034. doi: 10.3389/fpsyg.2024.1477034
Received: 06 August 2024; Accepted: 25 November 2024;
Published: 16 December 2024.
Edited by:
Michael Frass, Medical University of Vienna, AustriaReviewed by:
David Tomasi, Vermont Academy of Arts and Sciences, United StatesCopyright © 2024 Bernardini and Dei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Andrea Dei, ZGVpLmFuZHJlYTE5NDNAZ21haWwuY29t
†These authors have contributed equally to this work
‡ORCID: Andrea Dei orcid.org/0009-0006-1653-5167